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Louga, where the nomadic pastoral economy and the sedentary agricultural economy coexist, provides a particular environment to study the therapeutic itinerary of the population. In this region, as in developing countries, the great majority of people have a low income. As a consequence, recourse to modern medicine has economical and geographical limitations and traditional medicine is preferred for its accessibility. However, practices show simultaneous recourse to both health care systems. Another widespread practice not to be neglected is self-medication, in which both modern drugs and products derived from the traditional pharmacopoeia are employed. This research deals with all health practices across a geographic area marked by a strong traditional influence. The study of the choice of treatment in such a context traces the laborious therapeutic itinerary of each patient in search of health improvement.

Background: Research shows that maternal obesity leads not only to adverse pregnancy outcomes but also can act as a predictor of poor health of future generations. The Public Health Madison & Dane County Fetal and Infant Mortality Review Board observed poor health associated with prepregnancy BMI > or = 25, prompting further exploration of this issue in the Dane County, Wisconsin population., Objective: This is a descriptive epidemiologic study of the problem of maternal overweight defined as prepregnancy BMI > or = 25 in Dane County., Methods: Data were abstracted from the Secure Public Health Electronic Records Environment (SPHERE) on births in Dane County in 2011. Risk ratios were used to determine associations between race, education, parity, gravidity, and place of residence and maternal overweight. A t test was completed to determine differences in mean age of overweight and healthy weight mothers., Results: Approximately half (50.6%) of Dane County mothers in 2011 were overweight or obese prepregnancy. Results showed increased risk of overweight for black mothers and multiparous/multigravidous mothers. There was no difference in mean age of overweight and healthy weight mothers. Overweight rates varied considerably by ZIP code of residence., Conclusion: Rates of maternal overweight vary significantly in Dane County by social and demographic factors. This information can be used to design and target interventions and monitor trends over time.

Objectives: In Dane County, Wisconsin, the black-white infant mortality gap started decreasing from 2000 and was eliminated from 2004 to 2007. Unfortunately, it has reappeared since 2008. This paper examines risk factors and levels of prenatal care to identify key contributors to the dramatic decline and recent increase in black infant mortality and extremely premature birth rates., Methods: This retrospective cohort study analyzed approximately 100,000 Dane County birth, fetal, and infant death records from 1990 to 2007. Levels of prenatal care received were categorized as "less-than-standard," "standard routine" or "intensive." US Census data analysis identified demographic and socioeconomic changes. Infant mortality rates and extremely premature ( < or = 28 weeks gestation) birth rates were main outcome measures. Contributions to improved outcomes were measured by calculating relative risk, risk difference and population attributable fraction (PAF). Mean income and food stamp use by race were analyzed as indicators of general socioeconomic changes suspected to be responsible for worsening outcomes since 2008., Results: Risk of extremely premature delivery for black women receiving standard routine care and intensive care decreased from 1990-2000 to 2001-2007 by 77.8% (95% CI = 49.9-90.1%) and 57.3% (95% CI = 27.6-74.8%) respectively. Women receiving less-than-standard care showed no significant improvement over time. Racial gaps in mean income and food stamp use narrowed 2002-2007 and widened since 2008., Conclusions: Prenatal support played an important role in improving black birth outcomes and eliminating the Dane County black-white infant mortality gap. Increasing socioeconomic disparities with worsening US economy since 2008 likely contributed to the gap's reappearance.

This study was undertaken to investigate the vasodilatory effect of an aqueous extract of Elaeis guineensis Jacq (EGE) in the porcine coronary artery and elicit its possible mechanism(s) of action. Vascular effects of crude extract of dried and powdered leaves of Elaeis guineensis were evaluated on isolated coronary arteries on organ chambers. Determination of eNOS expression and the phosphorylation level of eNOS were determined by Western blot analysis. In the presence of indomethacin, EGE caused pronounced relaxations in endothelium-intact but not in endothelium-denuded coronary artery rings. Relaxations to EGE were significantly reduced by N(ω)-nitro-L-arginine (L-NA, a competitive inhibitor of NO synthase), slightly but not significantly by charybdotoxin plus apamin (two potent inhibitors of EDHF-mediated responses) and abolished by the combination of L-NA and charybdotoxin plus apamin. Relaxations to EGE were abolished by the membrane permeant, SOD mimetic, MnTMPyP, and significantly reduced by wortmannin, an inhibitor of PI3-kinase. Exposure of endothelial cells to EGE increased the phosphorylation level of eNOS at Ser1177 in a time and concentration-dependent manner. MnTMPyP abolished the EGE-induced phosphorylation of eNOS.In conclusion, the obtained data indicate that EGE induces pronounced endothelium-dependent relaxations of the porcine coronary artery, which involve predominantly NO. The stimulatory effect of EGE on eNOS involves the redox-sensitive phosphorylation of eNOS at Ser1177 most likely via the PI3-kinase pathway.

Aim: The general objective of this study was to agree an inventory of fixtures of clinical trials done in Dakar, in order to make recommendations to improve the quality of clinical trials in Senegal., Method: We have done a survey from mars to may 2007, with investigators of the two biggest Senegalese university teaching hospitals and to the pharmacy management and the ethical committee., Results: Our key results showed: 1) a small participation rate of teachers to clinical trials (11 on 37 interviewed); 2) that the principal sponsor is pharmaceutical industry; 3) that most of investigators have not degree in clinical trials; 4) that most pathologies concerned were malaria and AIDS; 5) that there are regulations related to clinical trials in Senegal., Conclusion: This study shows the necessity to integrate, in Senegal, clinical trials in the curricula of students training.

Aim: The general objective of this study was to agree an inventory of fixtures of clinical trials done in Dakar, in order to make recommendations to improve the quality of clinical trials in Senegal., Method: We have done a survey from mars to may 2007, with investigators of the two biggest Senegalese university teaching hospitals and to the pharmacy management and the ethical committee., Results: Our key results showed: 1) a small participation rate of teachers to clinical trials (11 on 37 interviewed); 2) that the principal sponsor is pharmaceutical industry; 3) that most of investigators have not degree in clinical trials; 4) that most pathologies concerned were malaria and AIDS; 5) that there are regulations related to clinical trials in Senegal., Conclusion: This study shows the necessity to integrate, in Senegal, clinical trials in the curricula of students training., (Copyright © 2008 Société Française de Pharmacologie et de Thérapeutique. Publié par Elsevier Masson SAS.)

Objective: The objective of this study was to evaluate knowledge and attitudes of general practitioners of the private sector, in Dakar, concerning prescription of benzodiazepines, in order to make, possibly, recommendations for their rational use., Method: A survey was done in 2005 with a representative sample of 55 medical doctors. Medical doctors filled in the questionnaire which focused on the main benzodiazepines' indications, those prescribed and their rules of prescription., Results: The main indications were anxiety, convulsions, epilepsy and insomnia and the benzodiazepines prescribed in first intention were prazepam against anxiety and insomnia and diazepam against convulsions and epilepsy. Practically 17% of medical doctors ignored the existence of limited period of benzodiazepine use and 70.9% of medical doctors considered their training on benzodiazepines insufficient., Conclusion: These results show the necessity to base continuous training for these general practitioners on the pharmacology of benzodiazepines.

Doping in sports is as old as sports, but it grew considerably during the 20th century with the arrival in stadiums during the 1990s of amphetamines and anabolic steroids as well as such peptide hormones as erythropoietin. The international fight against doping took a giant step forward in 1999 with the creation of the world antidoping agency (WADA). This study is part of that fight. It follows an earlier survey of retail pharmacists in Senegal and aims to evaluate the knowledge about doping of doctors belonging to the Senegalese Association of Sports Medicine and to assess their attitude towards this phenomenon. Its goal is to determine how best to involve them in preventive actions. We conducted a survey in 2001 and randomly selected and interviewed 60 of the 92 doctors in the association. The questionnaire focused on three areas: their knowledge of doping, their attitudes to it, and the means of prevention that they proposed. The results showed that only 11 of the 60 doctors knew the definition of doping and 15% of doctors could not cite any family of doping products. They were aware mainly of testosterone and other anabolic steroids (84.3%), then amphetamines and other stimulants (64.7%), and finally peptide hormones (58.8%). The subjects mentioned blood doping and pharmacological manipulations as forbidden methods. They considered that the four groups of drugs most often used by athletes for doping were, in descending order, anabolic steroids, stimulants, peptide hormones and corticoids. Eighty per cent of doctors think that Senegalese athletes use doping products and that the sports most involved are football, wrestling, track and field and basketball. They also think that doping is a form of drug addiction and a public health problem. Eleven doctors (18%) said they had been contacted for information on use of doping products. The interviewees consider that the three best methods of prevention include information about side effects, unannounced urine and blood tests, and sanctions. This work shows that Senegalese athletes may use doping; it contains no direct proofs but many indirect indicators. Success against doping requires preventive activities that should be conducted jointly for trainers, sports federations and doctors of the Senegalese Association of Sports Medicine and then by all of them for athletes, who are the primary targets of any prevention campaign.